Abstract
Amaç: Kemik iliği kor biyopsileri, kemik iliğinin hücresel özelliklerini, solid organ tümörü
metastazlarını veya hematolojik malign tutulumlarını belirlemek için yapılan önemli incelemelerdir. Kor biyopsinin uzunluğu ve kalitesi doğru tanı konulmasını ve klinik süreci
etkilemektedir. Bu çalışmada kemik iliği kor biyopsi uzunluğunun tanı sürecine olan
etkisinin araştırılması amaçlanmıştır.
Gereç ve
Yöntem: Çalışmamızda bölümümüze son bir yıl içerisinde gelmiş olan kemik iliği
biyopsi materyallerinin uzunlukları ve içerdikleri intertrabeküler alanlar mikroskop altında
incelenmiş ve uzunlukları milimetre cinsinden ölçülmüştür. Kor biyopsiler; uzunlukları 15
milimetreye eşit ve/veya üzerinde ise yeterli grup, 15 milimetrenin altında ise yetersiz grup
şeklinde iki gruba ayrılmıştır.
Bulgular: Kor biyopsi uzunluğu 185 olguda (%48,9) yeterliydi. 194 olguda (%51,1) ise
kemik iliği kor biyopsi uzunluğu 15 mm altında ölçüldü. Olguların 192 (%50,5) tanesine
spesifik tanı (Miyeloproliferatif Neoplazi, Lenfoma tutulumu, Lösemi tanısı ve benzeri)
konuldu. 188 olgunun (%49,5) ise selülaritesi değerlendirip görülen bulgular özetlendi.
Spesifik tanı konabilen 192 olgunun 116 tanesinde (%62,4) biyopsi uzunluğu yeterli iken,
spesifik tanı konulamayan 188 olgunun 118'inde (%62,8) biyopsi uzunluğu yetersizdi. Kor
biyopsi uzunluğu ile spesifik tanı konulması arasında doğrudan kuvvetli bir ilişki vardı
(p≤0,01).
Sonuç: Kemik iliği kor biyopsi materyalleri güvenilir tanı için optimal büyüklükte alınmalı
ve aspirasyon yaymaları ile birlikte değerlendirilmelidir. Ayrıca klinikopatolojik iş birliği tanı
güvenirliğini artırmaktadır.
Keywords
References
- 1. Lee SH, Erber WN, Porwıt A, Tomonaga M, Peterson C. ICSH guidelines for the standardization of bone marrow specimens and reports. Int Jnl Lab Hem 2008;30:349-364.
- 2. Stifter S, Babarović E, Valković Tet al. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagn Pakhol 2010;18:5-30.
- 3. Brestoff JR, Toland A, Afaneh K et al. Bone Marrow Biopsy Needle Type Affects Core Biopsy Specimen Length and Quality and Aspirate Hemodilution. Am J Clin Pathol 2019;7:185-193.
- 4. Swerdlow SH, Campo E, Harris NL et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Fourth Edition. Lyon: International Agency for Research on Cancer 2017:16-27.
- 5. Kaur M, Singh Rana AP, Kapoor S, Puri A. Diagnostic value of bone marrow aspiration and biopsy in routine hematology practice. J Clin Diagn Res 2014;8:13-16.
- 6. Lynch DW, Stauffer SL, Rosenthal NS. Adequacy of powered vs manual bone marrow biopsy specimens: a retrospective review of sequential marrow aspirates and biopsies in 68 patients. Am J Clin Pathol 2015;143:535-539.
- 7. Merzianu M, Groman A, Hutson A et al. Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study. Am J Clin Pathol 2018;150:393-405.
- 8. Marinelli LM, Fang H, Howard MT et al. Bone Marrow Biopsy Operator Experience and Impact on Aspirate, Biopsy, and Ancillary Testing Quality. Mayo Clin Proc Inn Qual Out September 2018;2:241-247.
- 9. Maiti A, Short N J, Verstovsek S, Powers CA, Fullmer CA, Reyes SR, Bueso-Ramos CE. Quality and Cost Comparison of Powered Versus Manual Bone Marrow Biopsy Devices in Patients with Myelofibrosis. Leuk Lymphoma 2017;58:2508-2510.
- 10. Goldblum JR, Lamps LW, McKenney JK, Myers JL. Rosai and Ackerman`s Surgical Pathology 11th ed. Philadelphia: 2018;23:2047-2049.
- 11. Gilotra M, Gupta M, Singh S, Sen R. Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study. J Lab Physicians 2017; 9:182-189.
Abstract
Objective: Bone marrow core biopsy is an important examination to reveal the cellular
features of the bone marrow, solid organ tumor metastases or involvement of hematological malignant diseases. The size and quality of the biopsy affects the diagnosis and
clinical process. In this study, it was aimed to investigate the effect of the adequacy of
bone marrow biopsy on the diagnostic process.
Material and Method: In the study, the lengths of bone marrow biopsy materials and the
intertrabecular areas they contain were examined under the microscope and their lengths
were measured. Biopsies were divided into two groups as adequate group if their length is
equal to and above 15 millimeters, and insufficient group if they are less than 15
millimeters.
Results: There are 185 cases (48.9%) of bone marrow length over 15 mm (sufficient
group). In 194 cases (51.1%), the bone marrow length was below 15 mm. We were able to
give specific diagnosis (Myeloproliferative Neoplasia, Lymphoma involvement, diagnosis
of Leukemia etc.) to 192 (50.5%) of the cases. We evaluated the popularity of 188 cases
(49.5%) and summarized the findings we saw or just wrote the biopsy size in the comment
section. While the biopsy length was sufficient in 116 (62.4%) of 192 cases with specific diagnosis, 118 (62.8%) of 188 cases without specific diagnosis, biopsy length was
insufficient. There is a strong correlation between biopsy adequacy and specific
diagnosis (p≤0.01).
Conclusion: Bone marrow core biopsy samples should be taken in an optimal size for
reliable diagnosis and evaluated with aspirations. In addition, clinicopathological
cooperation increases diagnostic reliability.
References
- 1. Lee SH, Erber WN, Porwıt A, Tomonaga M, Peterson C. ICSH guidelines for the standardization of bone marrow specimens and reports. Int Jnl Lab Hem 2008;30:349-364.
- 2. Stifter S, Babarović E, Valković Tet al. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagn Pakhol 2010;18:5-30.
- 3. Brestoff JR, Toland A, Afaneh K et al. Bone Marrow Biopsy Needle Type Affects Core Biopsy Specimen Length and Quality and Aspirate Hemodilution. Am J Clin Pathol 2019;7:185-193.
- 4. Swerdlow SH, Campo E, Harris NL et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Fourth Edition. Lyon: International Agency for Research on Cancer 2017:16-27.
- 5. Kaur M, Singh Rana AP, Kapoor S, Puri A. Diagnostic value of bone marrow aspiration and biopsy in routine hematology practice. J Clin Diagn Res 2014;8:13-16.
- 6. Lynch DW, Stauffer SL, Rosenthal NS. Adequacy of powered vs manual bone marrow biopsy specimens: a retrospective review of sequential marrow aspirates and biopsies in 68 patients. Am J Clin Pathol 2015;143:535-539.
- 7. Merzianu M, Groman A, Hutson A et al. Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study. Am J Clin Pathol 2018;150:393-405.
- 8. Marinelli LM, Fang H, Howard MT et al. Bone Marrow Biopsy Operator Experience and Impact on Aspirate, Biopsy, and Ancillary Testing Quality. Mayo Clin Proc Inn Qual Out September 2018;2:241-247.
- 9. Maiti A, Short N J, Verstovsek S, Powers CA, Fullmer CA, Reyes SR, Bueso-Ramos CE. Quality and Cost Comparison of Powered Versus Manual Bone Marrow Biopsy Devices in Patients with Myelofibrosis. Leuk Lymphoma 2017;58:2508-2510.
- 10. Goldblum JR, Lamps LW, McKenney JK, Myers JL. Rosai and Ackerman`s Surgical Pathology 11th ed. Philadelphia: 2018;23:2047-2049.
- 11. Gilotra M, Gupta M, Singh S, Sen R. Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study. J Lab Physicians 2017; 9:182-189.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | February 27, 2022 |
| Submission Date | August 13, 2021 |
| Acceptance Date | December 21, 2021 |
| Published in Issue | Year 2022 Volume: 4 Issue: 1 |
Hitit Medical Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).